A pilot study for a structured, time-limited therapy group for sexually abused pre-adolescent children.

The critical role of specific types of mastery skill development in the treatment of sexually abused children is explored, and defense mechanisms of "invulnerable children," who function adequately despite trauma and stress, are described. The authors describe their development of structured group therapy techniques designed to foster these types of mastery skills with sexually abused children aged 6 to 8. These techniques include development of intellectualization defenses through original coloring books and therapeutic board games, cathartic exploration of feelings through structured art and storytelling exercises, cognitive relabeling and self-esteem building through role-play, "chants and cheers," homework shared with mothers, and other structured group procedures designed to develop specific coping skills.

Structured role assignment and other techniques for facilitating process in adolescent psychotherapy groups.

The application of various types of techniques for structuring the interchange and feedback process in adolescent psychotherapy groups is described. Techniques include random assignment of "roles" for each member during sessions, "parent hot seat" exercises, group goal booklets, and negotiation exercises. These have proved helpful in ensuring effective group participation, providing practice in social skills and verbalization of feelings, and in the development of other specific mastery skills.

Biofeedback, cognitive training and relaxation techniques as multimodal adjunct therapy for hospitalized adolescents: a pilot study.

Modifications and adjuncts to traditional therapy techniques appear to be necessary for successfully treating hospitalized adolescents with impaired social and verbal skills, and a history of acting-out behavior. Modified therapy groups were combined with a structured biofeedback and cognitive training program to help these adolescents control anger and modify their behavior. Used in conjunction with training and practice in relaxation techniques, this multimodal treatment approach appeared to be helpful in both reducing incidents of acting out on residential units, and in reaching individualized therapeutic goals. The present paper describes use of this multimodal approach within selected residential settings, and outlines the structured materials developed by the authors.

Legal issues affecting residential child care workers.

Most respondents felt that child care workers' legal concerns should be addressed by requiring (1) thorough, legally approved written procedures and guidelines for all day-to-day procedures and responsibilities; (2) legally approved comprehensive record-keeping systems; and (3) access to legal support and counsel. When child care workers follow legal guidelines and a facility's procedure manuals carefully, documenting their activities in an approved record-keeping system, they can expect to be in a positive situation in any legal contest and to have behavior measured from a legal standpoint by a standard described as what a "reasonable person" would be expected to do in a similar situation and circumstance.

Environmental and personality similarities in case histories of suicide and self-poisoning by children under ten.

Research on suicide in latency age children is reviewed and case histories of two 9-year-old children who suicided by shooting themselves and one 7-year-old who died by self-poisoning are presented. Similarities in environmental and family histories, and in personality variables among these three cases have suggested underlying mechanisms in development and maintenance of symbiotically shared self-concept between parent and child which may be useful in helping to identify similar cases and in assessing potential for suicidal and self-destructive behavior in latency age children.

An experimental study of the effect of structured videotape feedback on adolescent group psychotherapy process.

Group psychotherapy with disturbed undersocialized adolescents requires modification of traditional group psychotherapy methods. The effectiveness of a structured, brief video-tape feedback and discussion on group psychotherapy process with this population was studied by an analysis of detailed ratings of each "statement", or process unit; in randomly selected videotapes from a control and experimental group during a nine-month period. Significant differences in level of intimacy of verbal content and in frequency of feedback about behavior in content indicate that this technique is effective in facilitating group psychotherapy goals.

Pre-therapy training for adolescents in group psychotherapy: contracts, guidelines, and pre-therapy preparation.

Although adolescents in psychotherapy groups have been described as requiring more structure and preparation than adults, and as generally showing more critical deficits in verbal feedback and other interpersonal skills necessary for successful group functioning, no specific, detailed programs for preparation and pretraining of adolescents for group therapy are described in the literature. The present paper outlines a specific program developed for outpatient adolescent psychotherapy groups which has successfully speeded development of group cohesion, increased expression of positive expectancies for treatment reduced time spent in "pass-time" discussion, decreased verbalized concerns over confidentiality issues, and facilitated growth of patient skills in giving and receiving verbal feedback.

Critical areas of therapists' functioning in adolescent group psychotherapy: a comparison with self-perception of functioning in adult groups by experienced and inexperienced therapists.

The results of the study's questionnaire has pointed toward some areas of significant differences between experienced and inexperienced therapists in their work with adults and adolescents. These differences appeared to emphasize some techniques and approaches which the experienced therapists have successfully modified for their work with adolescents, and may indicate some important gaps in typical training programs for group therapists. The results have been utilized recently by supervisors in a university affiliated training program for therapists, to predict and focus on trainees' adaptation of general group therapy techniques for work with adolescents. Some directions for further research were also suggested, such as a study of the effect of co-therapists' sex on adolescent group process, and the need for more specific and effective assessment measures of group process and progress in adolescent groups, which could be utilized by therapists at all levels of experience.

Legal issues in the treatment of adolescent psychiatric inpatients.

When planning a specialized adolescent treatment unit for a regional state mental hospital in North Carolina, staff of the child psychiatry training program explored several critical legal issues surrounding the admission, treatment, and discharge of minors, as well as issues of confidentiality. Through a question-and-answer format they conclude that, to help avoid conditions that could result in successful litigation against the hospital, parents, adolescents, and staff must have a documented, mutual agreement to and understanding of the techniques, procedures, and limitations of the treatment program. Such documentation could be provided through a signed treatment contract.

Adolescent parricide: a comparison with other adolescent murder.

The authors examined the available data for 10 adolescents who had been charged with parricide and compared these with data for matched groups of 10 adolescents charged with murdering another relative or a close acquaintance and 10 charged with murdering a stranger. They found significant differences between parricidal adolescents and other homicidal adolescents on personality, family, social, and follow-up adjustment variables.

Issues in developing psychotherapy groups for preschool children in outpatient clinics.

A survey of 10 randomly selected clinics indicated that only 1 offered group psychotherapy for preschool children. Reasons given for the lack of such programs resembled the resistances encountered in the authors' clinic. The authors describe the solutions they found in creating and running therapy groups for preschool children and in integrating parent counseling with this treatment. It is suggested that professional groups provide in-service training opportunities in this area to counteract resistances resulting from clinic staffs' perceived lack of experience and expertise.